AB0215 MAGNITUDE OF THE INFLUENCE BY JOINT INVOLVEMENT ON HEALTH ASSESSMENT QUESTIONNAIRE DISABILITY INDEX SCORE
Authors: I. Yoshii, S. Nishiyama
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> The Health Assessment Questionnaire Disability Index (HAQ-DI) is the best-known index for measuring functional capacity in patients with rheumatoid arthritis (RA). This index is well known to be influenced by disease activity, aging, joint deformities and pain. However, these parameters are related to each other and it remains unclear how joint involvement affects HAQ-DI in RA patients. <h3>Objectives</h3> The aim of this study is to determine how joint involvement affects HAQ-DI in RA patients using a retrospective cohort study. <h3>Methods</h3> Patients with RA who have been monitored since the first visit for tenderness and swelling of the whole body and limb joints, patient's global assessment (PGA), evaluator's global assessment (EGA), pain score using a visual analog scale (PS), and HAQ-DI at every visit were included in the study. The patient's mean age, HAQ score, PGA, EGA, C-reactive protein (CRP), and Sharp/van der Heijde score (SHS) were collected. Joint Index Vector (JIV) was used as an index of joint lesions. JIV represents the joint prevalence of the upper limb in X coordinates (Vx), the joint prevalence of the lower limb in Y coordinates (Vy), and the difference in joint prevalence between large and small joints in Z coordinates (Vz) [1]. The average value of the triaxial coordinates of the JIV was also collected. As a preliminary study, the correlation between the mean HAQ score of all cases collected and other parameters such as patient gender and serum albumin level (ALB) was evaluated using multivariate linear regression analysis. Statistical significance was set as less than 1.0*10<sup>-10</sup>. Next, the association of the HAQ score with other parameters at baseline, the association of the HAQ score after 1 year at baseline with other parameters at baseline and the change from baseline to 1 year, and the annual change in the HAQ score and other parameters at baseline and the annual change in these parameters were statistically evaluated using multivariate linear regression analysis. Statistical significance was set as less than 5.0%. <h3>Results</h3> A total of 601 patients in these 166 males and 435 females data were used in the study. The HAQ score positively correlated with male gender, older age, higher SHS, higher PGA, lower EGA, higher PS, higher Vy, and higher Vz with beta values of 0.09, 0.22, 0.17, 0.19, -0.12, 0.17, 0.07, and 0.11, respectively. The HAQ score at baseline positively correlated with older age, higher PGA, higher CRP, higher PS, higher SHS, and higher Vy at baseline with beta values of 0.26, 0.13, 0.21, 0.14, 0.14, and 0.10, respectively. The HAQ score at one year after the baseline positively correlated with older age, higher PS, and higher SHS at the baseline, and higher annual change of the PS with beta values of 0.26, 0.25, 0.22, and 0.15, respectively. The annual change of the HAQ score positively correlated with higher SHS and higher Vy at the baseline, and higher annual change of PS, Vx, Vy, and Vz with beta values of 0.04, 0.11, 0.04, 0.67, 0.43, and 0.09, respectively. <h3>Conclusion</h3> These results indicate that there is a close association between HAQ scores and aging, degree of pain, and joint deformities, and in addition, joint involvement also influences HAQ scores. In particular, changes in HAQ scores are governed by joint involvement. The effect of disease activity on HAQ scores will be largely governed by joint involvement. <h3>Reference</h3> [1]Nishiyama S, Sawada T, Nishino J, Tohma S. Joint index vector: a novel assessment measure for stratified medicine in patients with rheumatoid arthritis. Journal of Big Data. 2018;5(1):37. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.